A mother's attitude toward teenage sexuality, her comfort in talking about sexual matters and her religiousness can all significantly affect whether she communicates with her adolescent about condoms, according to a study of nearly 1,000 women in the United States and Puerto Rico.1 Seventy-three percent of women report discussing condoms with their teenager. Mothers who have greater skill or greater comfort in communicating about sex, those who feel that they have credible information about condoms and those who have the perception that their adolescent's friends are sexually active have elevated odds of speaking with their teenager about condoms. Mothers who believe that their teenager should wait until marriage to engage in sexual activity are less likely than those who do not share this belief to talk to them about condoms.
To determine what factors significantly affect mother-adolescent communication about condoms, researchers surveyed women and their 14-17-year-old children in three locations: Montgomery, Alabama; San Juan, Puerto Rico; and New York City. In separate interviews, which took place between October 1993 and June 1994, researchers asked mothers and their teenagers questions regarding their demographic characteristics and whether they had ever spoken together about condoms. The mothers were also asked questions about six areas thought to influence parent-child communication: their knowledge and information about topics related to sex, HIV and other sexually transmitted diseases; attitudes, beliefs and religiousness; perception of their teenager's risk; perception of their ability to discuss sex and condoms; beliefs about condom effectiveness; and endorsement of condom use by adolescents.
Researchers conducted bivariate and multivariate analyses on the survey data. An initial regression model examined the independent relationship between each demographic variable and communication about condoms. Individual regression models examined predictors within each of the six question areas, controlling for location, mother's age, mother's education, father's presence in the household and the adolescent's age and gender. A final model simultaneously examined all predictors found to be significant in the previous analyses.
Of the 907 mothers surveyed, 73% reported that they had spoken with their adolescent about condoms. In the bivariate analyses, the researchers identified numerous significant factors within each of the six question areas to be examined further in multivariate regression models. In the initial multivariate analysis, including only demographic factors, they found that women who lived in New York were more likely than those who lived in San Juan to have talked with their teenager about condoms (odds ratio, 2.3). The likelihood that a mother had spoken with her teenager about condoms rose as a mother's education increased and declined as her age increased (1.2 and 0.9, respectively); it was reduced if the father was present in the home (0.6).
The multivariate analysis of the knowledge and information question area included 12 factors, and of these, believing that she had enough information to discuss condoms and receiving information from a pamphlet, a doctor or the health department were found to be significantly associated with a mother's increased likelihood of having talked to her teenager about condoms (odds ratios, 2.6 and 2.0, respectively). In the regression model examining the mothers' attitudes, beliefs and religiousness, those who believed that their teenager should wait until marriage to have sex were 40% less likely than those who did not to talk to their adolescent about condoms (odds ratio, 0.6).
In the regression model looking at mothers' perception of their teenager's risk, those who perceived that their adolescent's friends were sexually active were more likely than those who did not to discuss condoms with their adolescent (odds ratio, 4.2). Of the four factors in the question area exploring mothers' perceptions of their ability to discuss sex, believing that they had good sexual communication skills and being comfortable with talking about condoms were significantly associated with elevated odds of mother-adolescent communication about condoms (1.1 and 1.3, respectively). Analysis of the factors in the question area on mothers' beliefs about condom effectiveness found that women who considered condoms effective in preventing HIV infection were more likely than those who did not to have talked to their teenager about condoms (1.4). Both of the factors in the model assessing the effects of mothers' beliefs about condom access--believing that schools should make condoms available to teenagers and believing that their teenager should carry condoms--were significantly associated with mothers' increased likelihood of having talked to their adolescent about condoms (2.1 and 1.5, respectively).
Most of the factors found significant in the multivariate analyses of the six question areas remained significant in the final regression model, which controlled for all factors simultaneously. The exceptions were the father's presence at home, the mother's belief in the efficacy of condoms and her belief that she had enough information to discuss the subject.
In light of their findings, the investigators conclude that "parents must learn that talking with adolescents about sex and condoms is associated with safer sexual behavior and with a reduced association between adolescents' own behavior and the adolescents' perception of their peers' behavior." They suggest that physicians and other health service providers can facilitate parent-teenager discussions by providing parents with credible information on sexuality and condoms, by informing parents of the benefit of such discussion and by impressing on parents the reality and risks of adolescent sexuality.--J. Rosenberg
1. Miller KS and Whitaker DJ, Predictors of mother-adolescent discussions about condoms: implications for providers who serve youth, Pediatrics, 2001, 108(2), <http://www.pediatrics.org/cgi/content/full/108/2/e28>.